THE ROLE OF INTERCELLULAR ADHESION MOLECULE (ICAM)-1 IN THE DETERMINATION OF CARDIOVASCULAR RISK IN PATIENTS WITH RHEUMATOID ARTHRITIS
Fedorovych K.M., Yatsyshyn R.I.
Summary. Introduction. Rheumatoid arthritis is consistently associated with increased cardiovascular risk. The search for new predictors of the development of atherosclerotic changes in the vascular bed is particularly significant today. The aim. To study the role of intercellular cell adhesion molecule (ICAM)-1 in the pathogenesis of cardiovascular pathology among patients with RA. Materials and methods. The study was conducted with the involvement of 120 patients with RA, divided into three groups based on disease activity according to the DAS-28 and 25 individuals in the control group. Determination of the intima-media thickness (IMT) was determined according to the standard method at the bifurcation of the external and internal carotid arteries. A subclinical atherosclerotic lesion was considered as IMT index >0.9 mm. At the same time, the presence of an atherosclerotic plaque was confirmed if the focal structure penetrated into the lumen of the carotid artery by at least 0.5 mm or 50% of the adjacent IMT value or the IMT reached >1.5 mm. Determination of ICAM-1 concentration in blood plasma was carried out using enzyme immunoassay (ELISA). Statistical analysis was performed using the Statistical Package for the Social Sciences version 26.0 software (SPSS Inc., Chicago, IL, USA). Results. Our study revealed more frequent atherosclerotic vascular damage among patients with RA compared to the control group of patients. In addition, ICAM-1 increase was associated with disease activity. The highest values of ISAM-1 were among patients in the group with high RA activity (394.8 [341.2–468.3]). The strongest direct correlation was observed between ICAM-1 and PSA, DAS-28 (r=0.557 and r=0.562, respectively). In the course of the study, it was possible to confirm the existence of a relationship between the increase in ICAM-1 concentration in the blood plasma and IMT [OR 1.1 (1.01–1.3), p<0.001]. The value of IСAM-1 concentration of 289.5 ng/ml was characterized by 85% sensitivity and 65% specificity in the course of checking the probability of an IMT increase over 0.9 mm. Conclusions. intercellular cell adhesion molecule (ICAM)-1 is a potential additional marker of early atherosclerotic vascular damage in patients with RA.
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